Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 1.076
Filter
1.
Rev. Bras. Neurol. (Online) ; 60(1): 16-22, jan.-mar. 2024. ilus, tab
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1555092

ABSTRACT

Introdução: A cefaleia pós punção dural (CPPD) é uma complicação da punção lombar, um procedimento que, apesar de bem tolerado, está sujeito a adversidades, ocorrendo devido a um vazamento persistente do líquido cefalorraquidiano (LCR) do local da punção dural. A incidência de CPPD pode estar relacionada às características dos pacientes e dos procedimentos. Notou-se que em mulheres jovens até 30 anos, o risco de CPPD é maior quando comparado aos homens, não apresentando diferença a partir da quinta década de vida. Objetivo: investigar os diferentes sintomas e efeitos gerados pelos diferentes tipos de agulha, como calibre e modo de inserção, que visem reduzir a CPPD. Métodos: Trata-se de uma revisão sistemática de literatura realizada no período de 2 de agosto a 20 de novembro de 2023 por meio de pesquisas no PubMed. Foram utilizados os descritores: "Post-Dural Puncture Headache" e suas variações do MeSH, sendo submetidos aos critérios de inclusão: estudos em humanos, nos últimos 10 anos, ensaios clínicos e ensaios clínicos controlados e randomizados. Para garantir a qualidade da revisão sistemática foi aplicada a lista de verificação PRISMA de 2020. Resultados: Após investigação estatística, observou-se que as agulhas 25W e 25S demandaram maior tempo médio para a coleta de LCR (15 e 7 min, respectivamente). Ao se comparar 25W com 20Q (3 min), 22S (5 min) e 25S quanto à esta variável, observouse diferença significativa em todas as comparações. Conclusão: As agulhas do tipo atraumática foram associadas com redução do risco de desenvolvimento de CPPD quando comparadas às convencionais. Foi constatado que, dentre as agulhas convencionais, a traumática de 25G é melhor para a prevenção de CPPD que a de 22G.


Introduction: Post-Dural Puncture Headache (PDPH) is a complication of lumbar puncture, a procedure that, despite being well-tolerated, is subject to adversities, occurring due to a persistent leakage of cerebrospinal fluid (CSF) from the site of dural puncture. The incidence of PDPH may be related to patient and procedural characteristics. It has been noted that in young women up to 30 years old, the risk of CPPD is higher compared to men, with no difference between sexes from the fifth decade of life onward. Objective: To investigate the different symptoms and effects generated by different types of needles, such as gauge and insertion method, aiming to reduce CPPD. Methods: Is a systematic literature review conducted from August to October 2023 through searches on PubMed. The descriptors "Post-Dural Puncture Headache" and its MeSH variations were used. A total of 1,839 articles were found, which were then subjected to inclusion criteria: studies conducted in the last 10 years, controlled trials, and randomized clinical trials. Results: After statistical investigation, it was observed that the 25W and 25S needles required a longer average time for cerebrospinal fluid collection (15 and 7 minutes, respectively). When comparing 25W with 20Q (3 minutes), 22S (5 minutes), and 25S regarding this variable, a significant difference was observed in all comparisons. Conclusion: Atraumatic needles were associated with a reduction in the risk of developing CPPD compared to conventional needles. It was found that among conventional needles, the traumatic 25G needle is better for preventing CPPD than the 22G needle.

2.
AlQalam Journal of Medical and Applied Sciences ; 7(2): 261-269, 2024. figures, tables
Article in English | AIM | ID: biblio-1552811

ABSTRACT

Post Dural Puncture Headache (PDPH) remains a prominent clinical concern to the present day and common complication seen in the field of anesthesiology and pain medicine. Identification of such risk factors is a crucial step in the rational modification of anesthetic practice and evaluation of therapeutic interventions. This study was conducted to demonstrate the incidence and risk factors of PDPH in patients after spinal Anesthesia during three days' post operations at general hospital in Tripoli, Libya. In this study certain factors related to patient history, baseline clinical state or anesthetic technique might be associated with an increased risk for this side effect, so it was collected historical, physiologic, and technical data to determine their association with PDPH. Out of total of 100 patients distributed over 5 different hospitals admitted over a period (from November 2020 to April 2021) 27% of them have a PDPH, while 92.5% of cases with PDPH are females, that 55.6% of PDPH cases are between 20 and 25 years old, and this percentage getting smaller as patients get older, most of the operations were caesarean section, at a rate of 58%, followed by lower abdominal surgeries with 19% of cases, and orthopedic surgeries with 17% of cases, while the lowest percentage was for the Urologic surgeries. 55% of cases with PDPH are classified as (case I), and 44% of them are classified as (case II), 81.5% of PDPH cases used noncutting needles. In this study the PDPH remains the most problem in hospitalized patients after spinal Anesthesia at Tripoli hospitals can be caused by variety of risk factors, associated with ASA physical states, nonprofessional technique, the females are more common than males and the percentage increasing in early age group


Subject(s)
Humans , Male , Female , Post-Dural Puncture Headache
3.
BrJP ; 7: e20240027, 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1557199

ABSTRACT

ABSTRACT BACKGROUND AND OBJECTIVES: Addressing secondary headaches in SARS-CoV-2 infection is crucial for effective management and care optimization. This review aims to synthesize data on headache characteristics and the impact of pre-existing headache conditions on these symptoms in SARS-CoV-2 infection. CONTENTS: A systematic search was conducted across multiple databases, including PubMed/Medline, Cochrane Collaboration, Web of Science, Scopus, LILACS, Embase, Open Grey, and Google Scholar, to identify studies on headache characteristics associated with SARS-CoV-2. The search focused on headache symptoms, characteristics, onset, duration, and response to treatment during and post-infection. Twenty-three studies met the inclusion criteria. Approximately 42.1% of individuals with SARS-CoV-2 reported headaches, resembling tension-type headaches and migraines. These headaches often manifested within the first three days of infection and could persist for up to four months. The data suggest that trigeminovascular activation and pro-inflammatory mediators play a significant role in headache pathogenesis, with pre-existing headache conditions exacerbating the symptoms. The importance of effective pain management strategies must be emphasized. CONCLUSION: Headache is a prevalent symptom among SARS-CoV-2 infected individuals, with significant implications for patient care. The findings emphasize the importance of recognizing headache characteristics in SARS-CoV-2 management and suggest that tailored clinical approaches are essential for effective symptom relief.


RESUMO JUSTIFICATIVA E OBJETIVOS: A abordagem das cefaleias secundárias na infecção pela SARS-CoV-2 é crucial para um manejo adequado e otimização do cuidado. Esta revisão tem como objetivo sintetizar os dados sobre as características da cefaleia e o impacto das condições pré-existentes de cefaleia sobre esses sintomas na infecção pela SARS-CoV-2. CONTEÚDO: Uma pesquisa sistemática foi realizada em vários bancos de dados, incluindo: Pubmed/Medline, Cochrane Collaboration, Web of Science, Scopus, LILACS, Embase, Open Grey e Google Scholar, com o objetivo de identificar estudos sobre as características da cefaleia associadas à SARS-CoV-2. A pesquisa se concentrou nos sintomas, nas características, no início, na duração e na resposta ao tratamento da cefaleia durante e após a infecção. Vinte e três estudos atenderam aos critérios de inclusão. Aproximadamente 42,1% dos indivíduos com SARS-CoV-2 relataram dores de cabeça, semelhantes a dores de cabeça do tipo tensional e enxaquecas. Essas cefaleias geralmente se manifestavam nos primeiros três dias de infecção e podiam persistir por até quatro meses. Os dados sugerem que a ativação trigeminovascular e os mediadores pró-inflamatórios desempenham um papel importante na patogênese da cefaleia, com condições preexistentes de cefaleia exacerbando os sintomas. A importância de estratégias eficazes de controle da dor deve ser enfatizada. CONCLUSÃO: A cefaleia é um sintoma prevalente entre os indivíduos infectados pela SARS-CoV-2, com significativas implicações no atendimento ao paciente. Os achados deste estudo enfatizam a importância do reconhecimento das características da cefaleia no manejo da SARS-CoV-2 e sugerem que abordagens clínicas personalizadas são essenciais para o alívio eficaz dos sintomas.

4.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1559697

ABSTRACT

Introducción: La hipotensión intracraneal espontánea es un síndrome causado por la disminución del volumen de líquido cefalorraquídeo consecuencia de su fuga al espacio extradural. Aunque la ICHD-3 proporciona un alto nivel de especificidad diagnóstica, esta enfermedad puede manifestarse de forma atípica. Hasta en un 30% no es posible establecer el punto de escape, pero con el refinamiento de los exámenes de imágenes este porcentaje se ha reducido a un 15%-20%. Actualmente, su manejo no se encuentra estandarizado y las recomendaciones se basan en evidencia de limitada calidad metodológica, además de la variabilidad de protocolos entre distintos centros. Desarrollo En esta revisión actualizamos los procedimientos diagnósticos y terapéuticos. Por un lado, analizamos el rol de la resonancia nuclear magnética de encéfalo y médula espinal completa como primer paso diagnóstico y, por otro lado, señalamos los exámenes destinados a determinar la fuga de líquido cefalorraquídeo. Tal es el caso de la mielo-resonancia, la mielo-tomografía computarizada, tanto estándar, dinámica y por sustracción digital, además de la cisternografía con 111-Indium-DPTA. Sin embargo, determinar cuál de estos exámenes es el óptimo es objeto de debate. Lo mismo ocurre con el tratamiento: reposo; parche sanguíneo epidural a ciegas, parche guiado por fluoroscopia o tomografía computarizada, parche de fibrina; o cirugía. Conclusiones Se requiere de una mayor investigación, especialmente con trabajos multicéntricos controlados, para una mejor comprensión de la fisiopatología, el diagnóstico por imágenes, los enfoques terapéuticos y evaluación objetiva de los resultados clínicos. Solo así se establecerán pautas diagnósticas y de tratamiento validadas.


Introducction: Spontaneous intracranial hypotension is a syndrome caused by decreased CSF volume secondary to its leakage into the extradural space Although ICHD-3 provides a high level of diagnostic specificity, manifestations may be atypical, making diagnosis challenging. The site of leakage may be undetermined in point Up to 30% of cases, although with recent refinement of imaging, this percentage has been reduced to 15-20%. Currently, management is not standardized and recommendations are based on inconclusive evidence, with variability of protocols between centres. Development. In this review, we update diagnostic and therapeutic procedures. We analyse the role of whole brain and spinal cord MRI as a first investigation and review tests aimed at determining cerebrospinal fluid leakage, such as MRI myelography, conventional CT myelography, dynamic CT myelography, and digital subtraction CT myelography, as well as 111-Indium-DPTA cisternography. Determining optimal use of these investigations remains a matter of debate. The same is true for treatment: rest, blind epidural blood patch, fluoroscopy or CT-guided epidural blood patch, fibrin patch and surgery are discussed. Conclusión: Further research, especially multicentre controlled studies, is required to improve understanding of pathophysiology, diagnostic imaging, therapeutic approaches and to objectively assess clinical outcomes. Only then will diagnostic and treatment guidelines be evidence-based.

5.
Braz. j. med. biol. res ; 57: e13155, 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1528104

ABSTRACT

Intracranial hemorrhage (ICH) is a serious medical condition that can lead to significant morbidity and mortality if not diagnosed and treated promptly. Early detection and treatment are essential for improving the outcome in patients with ICH. Near-infrared spectroscopy (NIRS) is a non-invasive imaging technique that has been used to detect changes in brain tissue oxygenation and blood flow in various conditions. The aim of this study was to investigate the predictive potential of NIRS for early diagnosis of ICH in patients presenting to the Emergency Department (ED) triage with headache. A total of 378 patients were included in the study. According to the final diagnosis of the patients, 4 groups were formed: migraine, tension-cluster headache, intracranial hemorrhage and intracranial mass, and control group. Cerebral NIRS values "rSO2" were measured at the first professional medical contact with the patient. The right and left rSO2 (RrSO2, LrSO2) were significantly lower and the rSO2 difference was significantly higher in the intracranial hemorrhage group compared to all other patient groups (P<0.001). The cut-off values determined in the receiver operating characteristics (ROC) analysis were RrSO2 ≤67, LrSO2 ≤67, and ΔrSO2 ≥9. This study found that a difference of more than 9 in cerebral right-left NIRS values can be a non-invasive, easy-to-administer, rapid, and reliable diagnostic test for early detection of intracranial bleeding. NIRS holds promise as an objective method in ED triage for patients with intracranial hemorrhage. However, further research is needed to fully understand the potential benefits and limitations of this method.

6.
Rev. Headache Med. (Online) ; 15(1): 35-37, 2024.
Article in English | LILACS | ID: biblio-1538177

ABSTRACT

BACKGROUND: Hemicrania continua is a rare form of cephalalgia featuring a chronic and persistent headache in only one side of the head. OBJECTIVES: In this report, we present a case of a patient with hemicrania continua and systemic lupus erythematosus (SLE). METHODS: We collected patient data through the electronic medical record. Afterward, we reviewed the literature regarding hemicrania continua and its pathophysiology and correlation with neurovascular alterations, inflammation, and SLE. RESULTS: A 42-year-old woman visited the emergency department due to worsening constant unilateral cephalalgia that had been present for the past 6 months. The patient reported a highly intense (10/10) headache in the entire left hemicrania that radiated to the left shoulder. During physical examination, she presented with nystagmus, vertigo, and aggravated cephalalgia associated to body movement and, despite having no optic nerve thickening. In addition, she had jaundice, tachycardia, and splenomegaly. Complimentary exams found deep anemia, depletion in complement system and anti-nuclear factors, suggesting a possible hemolytic anemia (AIHA) due to SLE. Treatment was initiated with hydrocortisone and prednisone, associated with amitriptyline, fluoxetine and diazepam, reaching full remission. CONCLUSION: These syndromes have aggravated each other, and possibly the explanation for the cephalalgia remission was the control of AIHA and SLE. It features a rare case in literature and thus warrants discussion.


INTRODUÇÃO: Hemicrania contínua é uma forma rara de cefaléia caracterizada por cefaleia crônica e persistente em apenas um lado da cabeça. OBJETIVOS: Neste relato apresentamos o caso de um paciente com hemicrania contínua e lúpus eritematoso sistêmico (LES). MÉTODOS: Coletamos dados dos pacientes por meio do prontuário eletrônico. Posteriormente, revisamos a literatura sobre a hemicrania contínua e sua fisiopatologia e correlação com alterações neurovasculares, inflamação e LES. RESULTADOS: Uma mulher de 42 anos recorreu ao serviço de urgência devido ao agravamento da cefaleia unilateral constante, presente nos últimos 6 meses. O paciente relatou cefaleia de alta intensidade (10/10) em toda a hemicrânia esquerda com irradiação para o ombro esquerdo. Ao exame físico apresentava nistagmo, vertigem e cefaléia agravada associada à movimentação corporal e, apesar de não apresentar espessamento do nervo óptico. Além disso, ela apresentava icterícia, taquicardia e esplenomegalia. Os exames complementares evidenciaram anemia profunda, depleção do sistema complemento e fatores antinucleares, sugerindo uma possível anemia hemolítica (AIHA) por LES. Iniciou-se tratamento com hidrocortisona e prednisona, associadas a amitriptilina, fluoxetina e diazepam, atingindo remissão completa. CONCLUSÃO: Essas síndromes agravaram-se mutuamente e possivelmente a explicação para a remissão da cefaléia foi o controle da AIHA e do LES. Apresenta um caso raro na literatura e, portanto, merece discussão.


Subject(s)
Humans , Headache Disorders/complications , Headache/complications , Rare Diseases/complications
7.
Rev. Headache Med. (Online) ; 15(1): 25-29, 2024. tab
Article in English | LILACS | ID: biblio-1538289

ABSTRACT

INTRODUCTION: Migraine is a chronic neurological disease, with a prevalence of 15.2% in Brazil. It is defined as an abnormal neurovascular reaction that occurs in a genetically vulnerable individual. Clinically manifests itself in recurrent episodes of headache associated with other symptoms, dependent on triggering factors. OBJECTIVE: To describe the epidemiological profile of hospital admissions of children and adolescents for migraine and other headache disorders. METHODS: This was a retrospective and descriptive epidemiological study carried out with data extracted from the Brazilian Unified Health System's Hospital Information System (SIH/SUS), indexed to the Department of Informatics of the Unified Health System (DATASUS). Hospital admissions were selected based on age groups, with an emphasis on children under nine years old and adolescents between 10 and 19 years old, residing in Brazil, between July 2013 and June 2023. RESULTS: Of 93,821 hospital admissions, there were 16,149 hospitalizations (17.2%) of children and adolescents (62.5% women and 37.5% men) due to migraine and other headache disorders. There was a predominance of the age group between 15 and 19 years old (50.2%), with a higher number of cases in the Southeast region (35.9%) and of brown ethnicity (42.6%). Over 10 years, there was a progressive increase in the number of hospital admissions, reaching a peak in 2019 (1,925/16,149; 11.9%), followed by a decline in 2020 and increasing again in subsequent years. Twenty-four deaths were found (24/16,149; 0.1%), 13 men and 11 women, with a predominance in the age group of 15 to 19 years (45.8%), coming from the Northeast region (58.3 %) and of brown ethnicity (58.4%). Deaths occurred predominantly in the years 2022 and 2023 (46.6%). CONCLUSIONS: There is an increase in the number of hospital admissions of children and adolescents due to migraine and other headache disorders with a consequent increase in the number of deaths.


INTRODUÇÃO: A enxaqueca é uma doença neurológica crônica, com prevalência de 15,2% no Brasil. É definida como uma reação neurovascular anormal que ocorre em um indivíduo geneticamente vulnerável. Manifesta-se clinicamente por episódios recorrentes de cefaleia associados a outros sintomas, dependentes de fatores desencadeantes. OBJETIVO: Descrever o perfil epidemiológico das internações hospitalares de crianças e adolescentes por enxaqueca e outras cefaleias. MÉTODOS: Estudo epidemiológico retrospectivo e descritivo realizado com dados extraídos do Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH/SUS), indexados ao Departamento de Informática do Sistema Único de Saúde (DATASUS). As internações hospitalares foram selecionadas com base em faixas etárias, com ênfase em crianças menores de nove anos e adolescentes entre 10 e 19 anos, residentes no Brasil, entre julho de 2013 e junho de 2023. RESULTADOS: De 93.821 internações hospitalares, ocorreram 16.149 internações (17,2%) de crianças e adolescentes (62,5% mulheres e 37,5% homens) por enxaqueca e outras cefaleias. Houve predomínio da faixa etária entre 15 e 19 anos (50,2%), com maior número de casos na região Sudeste (35,9%) e de etnia parda (42,6%). Ao longo de 10 anos, houve um aumento progressivo no número de internações hospitalares, atingindo um pico em 2019 (1.925/16.149; 11,9%), seguido de uma queda em 2020 e voltando a aumentar nos anos subsequentes. Foram encontrados 24 óbitos (24/16.149; 0,1%), 13 homens e 11 mulheres, com predomínio na faixa etária de 15 a 19 anos (45,8%), procedentes da região Nordeste (58,3%) e de cor parda. etnia (58,4%). Os óbitos ocorreram predominantemente nos anos de 2022 e 2023 (46,6%). CONCLUSÕES: Há um aumento no número de internações hospitalares de crianças e adolescentes por enxaqueca e outras cefaleias com consequente aumento no número de mortes.


Subject(s)
Child , Adolescent , Headache Disorders/complications , Headache/diagnosis , Hospitalization/statistics & numerical data
8.
Rev. Headache Med. (Online) ; 15(1): 7-12, 2024. tab
Article in English | LILACS | ID: biblio-1551344

ABSTRACT

BACKGROUND: In 2020, the first vaccines were approved, according to the WHO. However, speculations arose regarding their efficacy and post-vaccination adverse events (AEFV). OBJECTIVE: To evaluate the prevalence of headache as AEFI from the SARSCoV-2 vaccine in Piauí, Brazil. METHODS: This is a quantitative, observational, cross-sectional, and prevalence study. Data were provided by the Post-Vaccination Adverse Event Information System (SI-AEFV), from reported cases from January to September 2021. Data were analyzed, and the research was approved by the UFPI Research Ethics Committee. RESULTS: A total of 2,008 cases were analyzed. Headache was reported in 752 cases (27.99%) as an AEFV after vaccination against SARS-CoV-2. In most cases, patients were from Teresina (67.62%), of brown race/ethnicity (52.67%), female (79.00%), and the majority were not healthcare professionals (54.27%). The most common age of patients, with the original data, was 33 years. After data correction, the most common age was 28 years. The majority of these cases were not severe (96.44%), and the majority of cases were associated with the first dose of the Covid-19-Covishield-Oxford/AstraZeneca vaccine (43.18%).CONCLUSION: Thus, it is concluded from the partial analysis of the results that headache is the most common adverse event after vaccination against SARS-CoV-2. The profile of patients with the most notifications was brown women aged 30 to 40 years who received the first dose of the Covid-19-Covishield-Oxford/AstraZeneca vaccine. Regarding the severity of events, the vast majority were considered non-severe, and no deaths were mentioned, demonstrating the safety of immunobiologicals.


FUNDAMENTO: Em 2020, foram aprovadas as primeiras vacinas, segundo a OMS. No entanto, surgiram especulações quanto à sua eficácia e eventos adversos pós-vacinais (EAPV). OBJETIVO: Avaliar a prevalência de cefaleia como EAPV da vacina SARSCoV-2 no Piauí, Brasil. MÉTODOS: Trata-se de um estudo quantitativo, observacional, transversal e de prevalência. Os dados foram fornecidos pelo Sistema de Informação de Eventos Adversos Pós-Vacinação (SI-AEFV), dos casos notificados no período de janeiro a setembro de 2021. Os dados foram analisados ​​e a pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da UFPI. RESULTADOS: Foram analisados ​​2.008 casos. Cefaleia foi relatada em 752 casos (27,99%) como EAPV após vacinação contra SARS-CoV-2. Na maioria dos casos, os pacientes eram procedentes de Teresina (67,62%), de raça/etnia parda (52,67%), do sexo feminino (79,00%) e a maioria não era profissional de saúde (54,27%). A idade mais comum dos pacientes, com os dados originais, era de 33 anos. Após correção dos dados, a idade mais comum foi 28 anos. A maioria desses casos não foi grave (96,44%), e a maioria dos casos esteve associada à primeira dose da vacina Covid-19-Covishield-Oxford/AstraZeneca (43,18%).CONCLUSÃO: Assim, conclui-se a partir da análise parcial dos resultados de que cefaleia é o evento adverso mais comum após vacinação contra SARS-CoV-2. O perfil dos pacientes com mais notificações foi de mulheres pardas com idade entre 30 e 40 anos que receberam a primeira dose da vacina Covid-19-Covishield-Oxford/AstraZeneca. Quanto à gravidade dos eventos, a grande maioria foi considerada não grave e não foram mencionados óbitos, demonstrando a segurança dos imunobiológicos.


Subject(s)
Humans , Male , Female , Vaccines/immunology , Vaccination/adverse effects , COVID-19/virology , Patients/classification , Safety/standards , Health Personnel/organization & administration
9.
Rev. Headache Med. (Online) ; 15(1): 2-6, 2024. graf, ilus
Article in English | LILACS | ID: biblio-1551413

ABSTRACT

INTRODUCTION: Hypertension, or high blood pressure, is a common and serious health issue. It has no specific symptoms, and for that, it is called the silent killer. Migraine attacks may be alarming for those with hypertension.OBJECTIVE: This review aims to analyze the trending publications concerning hypertension and migraine.METHODS: This bibliometric analysis analyzed the trending publications about hypertension and migraine. The Scopus database was used, and the bibliometric analysis was applied to show the most productive authors, the journals that most contributed in this field, countries, institutions, and keywords used. Hypertension and migraine showed elevated growth in the published articles throughout the years.RESULTS: For the last ten years, from 2013 to 2022, there has been a dramatic increase, especially in the last few years in publications related to hypertension and migraine. The highest number of publications were in the United States, the most productive authors being Dodick, D.W. and Pezzini, A., Harvard Medical School had the most published articles; and Headache journal was on the top 10 journals that had publications on this subject.CONCLUSION: Migraine is recently considered a sign of hypertension, and this bibliometric analysis focused on the remarkable interest that has appeared in the research community


INTRODUÇÃO: A hipertensão, ou pressão alta, é um problema de saúde comum e grave. Não apresenta sintomas específicos e por isso é chamado de assassino silencioso. As crises de enxaqueca podem ser alarmantes para quem tem hipertensão.OBJETIVO: Esta revisão tem como objetivo analisar as tendências de publicações sobre hipertensão e enxaqueca.MÉTODOS: Esta análise bibliométrica analisou as tendências de publicações sobre hipertensão e enxaqueca. Foi utilizada a base de dados Scopus e aplicada a análise bibliométrica para mostrar os autores mais produtivos, os periódicos que mais contribuíram nesta área, países, instituições e palavras-chave utilizadas. Hipertensão e enxaqueca apresentaram crescimento elevado nos artigos publicados ao longo dos anos.RESULTADOS: Nos últimos dez anos, de 2013 a 2022, houve um aumento dramático, especialmente nos últimos anos, nas publicações relacionadas à hipertensão e enxaqueca. O maior número de publicações ocorreu nos Estados Unidos, sendo os autores mais produtivos Dodick, D.W. e Pezzini, A., Harvard Medical School tiveram o maior número de artigos publicados; e Headache Journal esteve entre os 10 principais periódicos que tiveram publicações sobre o assunto.CONCLUSÃO: A enxaqueca é recentemente considerada um sinal de hipertensão, e esta análise bibliométrica focou no notável interesse que tem surgido na comunidade de pesquisa


Subject(s)
Humans , Male , Female , Adult
10.
Rev. cuba. med ; 62(4)dic. 2023.
Article in Spanish | CUMED, LILACS | ID: biblio-1550894

ABSTRACT

Introducción: El neumoencéfalo (sinonimia: aerocele o neumatocele intracerebral), se define como la presencia de gas dentro de cualquiera de los compartimentos intracraneales (intraventricular, intraparenquimatosa, subaracnoidea, subdural y epidural). Objetivo: Describir los hallazgos clínicos, estudios complementarios, conducta terapéutica y evolución de un caso con neumoencéfalo como complicación de bloqueo regional epidural por radiculopatía lumbosacra. Presentación de caso: Se presentó un paciente masculino de 57 años de edad que comenzó con un cuadro súbito de desorientación, excitabilidad psicomotriz y convulsiones tónico-clónicas, a partir de una inyección epidural de metilprednisolona como método analgésico. Conclusiones: El caso presentado exhibió manifestaciones neurológicas inespecíficas, la aparición súbita posterior al proceder invasivo hizo sospechar en un evento neurológico agudo o fenómeno tromboembólico. Los estudios complementarios como la tomografía axial computarizada craneal simple, permitió su diagnóstico para tener una conducta consecuente. El manejo conservador del neumoencéfalo como complicación del uso de anestesia epidural, constituyó una conducta terapéutica eficaz y repercutió en la satisfactoria evolución del paciente(AU)


Introduction: Pneumocephalus (synonym: aerocele or intracerebral pneumatocele), is defined as the presence of gas within any of the intracranial compartments (intraventricular, intraparenchymal, subarachnoid, subdural and epidural). Objective: To describe the clinical findings, complementary studies, therapeutic conduct and evolution of a case with pneumocephalus as a complication of regional epidural block due to lumbosacral radiculopathy Case presentation: A 57-year-old male patient was presented who began with a sudden episode of disorientation, psychomotor excitability and tonic-clonic seizures, following an epidural injection of methylprednisolone as an analgesic method. Conclusions: The case presented exhibited non-specific neurological manifestations, the sudden appearance after the invasive procedure raised suspicion of an acute neurological event or thromboembolic phenomenon. Complementary studies such as simple cranial computed axial tomography, allowed its diagnosis to have a consistent conduct. The conservative management of pneumocephalus as a complication of the use of epidural anesthesia constituted an effective therapeutic approach and had an impact on the patient's satisfactory evolution(AU)


Subject(s)
Humans , Male , Middle Aged , Radiculopathy/complications , Methylprednisolone/therapeutic use , Pneumoencephalography/methods , Tomography, Spiral Computed/methods , Anesthesia, Epidural/methods
11.
Distúrbios Comun. (Online) ; 35(4): e63695, 31/12/2023.
Article in English, Portuguese | LILACS | ID: biblio-1552998

ABSTRACT

Introdução: A migrânea é um tipo de cefaleia primária incapacitante que, quando associada a crises de vertigem, configura-se migrânea vestibular. Objetivo: Verificar quais as principais manifestações clínicas da migrânea vestibular em adolescentes. Métodos: Trata-se de uma revisão integrativa da literatura, cujas buscas foram executadas nas bases de dados eletrônicas PubMed/Medline, Scientific Electronic Library Online (SciELO), e Portal da Biblioteca Virtual em Saúde (BVS), em junho de 2022. Foram incluídas publicações entre o ano 2012 e o mês de junho de 2022; estudos observacionais e ensaios clínicos envolvendo seres humanos, nos quais o objetivo fosse avaliar indivíduos com idades entre 12 e 19 anos com diagnóstico de migrânea vestibular e verificar suas principais manifestações clínicas nessa população. Resultados: Todos os estudos mencionaram um maior percentual de meninas nas amostras, porém a diferença entre os sexos para os diferentes diagnósticos não foi avaliada em todas as pesquisas. Conclusão: Verificou-se, com a presente revisão, que as manifestações clínicas da migrânea na adolescência são semelhantes às da população adulta. (AU)


Introduction: Migraine is a disabling type of primary headache that, when associated with vertigo attacks, constitutes vestibular migraine. Objective: To investigate the main clinical findings of vestibular migraine in adolescents. Methods: This is an integrative literature review, with searches conducted in the electronic databases PubMed/Medline, Scientific Electronic Library Online (SciELO), and the Virtual Health Library Portal (BVS) in June 2022. Publications from the year 2012 to June 2022 were included; observational studies and clinical trials involving human subjects, in which the objective was to assess individuals aged 12 to 19 years diagnosed with vestibular migraine and investigate their main clinical findings in this population. Results: All studies mentioned a higher percentage of girls in the samples; however, the difference between sexes for different diagnoses was not assessed in all studies. Conclusion: With this review, it was found that the clinical findings of migraine in adolescence are similar to those in the adult population. (AU)


Introducción: La migraña es em tipo de dolor de cabeza adolescente incapacitante que, cuando se dolesc em ataques de vértigo, constituye la migraña vestibular. Objetivo: Investigar las principales manifestaciones clínicas de la migraña vestibular em adolescentes. Métodos: Se trata de em revisión integradora de la literatura, em búsquedas realizadas em las bases de datos electrónicas PubMed/Medline, Scientific Electronic Library Online (SciELO) y el Portal de la Biblioteca Virtual em Salud (BVS) em junio de 2022. Se incluyeron publicaciones desde el año 2012 hasta junio de 2022; dolescê observacionales y ensayos clínicos que involucraran a sujetos humanos, en los cuales el objetivo fuera evaluar adolescentes de 12 a 19 años en diagnóstico de migraña vestibular e investigar sus principales manifestaciones clínicas em esta población. Resultados: Todos los adolescentes mencionaron en mayor porcentaje de niñas en las muestras; sin embargo, la diferencia entre los sexos para diferentes diagnósticos no fue evaluada en todos los adolescentes. Conclusión: En esta revisión, se descobrió que las manifestaciones clínicas de la migraña en la dolescência son similares a las de la población adulta. (AU)


Subject(s)
Humans , Adolescent , Migraine Disorders/physiopathology , Vertigo , Adolescent , Dizziness
12.
Medicina (B.Aires) ; 83(5): 762-771, dic. 2023. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1534880

ABSTRACT

Resumen La revisión consideró los puntos de conflicto que pue dan llevar a confusión en el uso diario de la clasificación internacional de las cefaleas (ICHD-III). Se evaluaron tanto las controversias al momento de confeccionar los criterios como las superposiciones producidas tras su utilización en la práctica diaria, argumentado a través de bibliografía científica. Como puntos relevantes, la anamnesis de un paciente con cefalea debe indicar la intensidad del dolor como así también la duración del episodio doloroso y si su localización es estrictamente unilateral. Estos puntos podrán ser de ayuda en los casos de dolor moderado que no cumplan en forma absoluta los criterios para ninguna de las cefaleas primarias, dilema frecuente en la práctica diaria.


Abstract The review considered points of conflict that may lead to confusion in the daily use of the International Classification of Headache Disorders (ICHD-III). Both the controversies at the time of preparing the criteria and the overlaps produced after their use in daily practice were evaluated, argued through scientific bib liography. As relevant points, the anamnesis of a patient with headache should indicate the intensity of the pain as well as the duration of the painful episode and if its location is strictly unilateral. These points may be help ful in cases of moderate pain that do not fully meet the criteria for any of the primary headaches, a frequent dilemma in daily practice.

13.
Arq. neuropsiquiatr ; 81(12): 1084-1097, Dec. 2023. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1527912

ABSTRACT

Abstract Migraine is one of the most prevalent and disabling diseases in the world. Migraine attack treatments and prophylactic treatments of this disease are essential to lessen its individual, social, and economic impact. This is a narrative review of the main drugs used for treating migraine, as well as the experimental models and the theoretical frameworks that led to their development. Ergot derivatives, triptans, non-steroid anti-inflammatory drugs, tricyclic antidepressants, beta-blockers, flunarizine, valproic acid, topiramate, onabotulinumtoxin A, ditans, monoclonal antibodies against CGRP and its receptor, and gepants are discussed. Possible therapeutic targets for the development of new drugs that are under development are also addressed. Many of the drugs currently in use for treating migraine were developed for the treatment of other diseases, but have proven effective for the treatment of migraine, expanding knowledge about the disease. With a better understanding of the pathophysiology of migraine, new drugs have been and continue to be developed specifically for the treatment of this disease.


Resumo A migrânea é uma das doenças mais prevalentes e incapacitantes do mundo. O tratamento da crise de migrânea e o tratamento profilático da doença são essenciais para diminuir o seu impacto individual, social e econômico. Este é um artigo de revisão narrativa. Revisamos as principais drogas usadas para a migrânea e os modelos experimentais e referenciais teóricos que levaram ao seu desenvolvimento. Foram abordados os derivados do ergot, triptanas, anti-inflamatórios não hormonais, antidepressivos tricíclicos, betabloqueadores, flunarizina, ácido valproico, topiramato, toxina onabotulínica do tipo A, os ditans, anticorpos monoclonais contra o CGRP e seu receptor e os gepants. Também foram abordados possíveis alvos terapêuticos para o desenvolvimento de novas drogas e drogas que estão em desenvolvimento para o tratamento da migrânea. Muitas das drogas usadas atualmente foram desenvolvidas para o tratamento de outras doenças e se mostraram efetivas para o tratamento da migrânea. Essas ajudaram a ampliar o conhecimento sobre a doença. Com o melhor entendimento da fisiopatologia da migrânea, novas drogas foram e estão sendo desenvolvidas especificamente para o tratamento dessa doença.

14.
Braz. J. Anesth. (Impr.) ; 73(6): 782-793, Nov.Dec. 2023. tab, graf
Article in English | LILACS | ID: biblio-1520392

ABSTRACT

Abstract Objective: To evaluate the efficacy and safety of trans-nasal Sphenopalatine Ganglion (SPG) block over other treatments for Post-Dural Puncture Headache (PDPH) management. Methods: A systematic literature search was conducted on databases for Randomized Controlled Trials (RCTs) comparing trans-nasal SPG blockade for the management of PDPH over other treatment modalities. All outcomes were pooled using the Mantel-Haenszel method and random effect model. Analyses of all outcomes were performed as a subgroup based on the type of control interventions (conservative, intranasal lignocaine puffs, sham, and Greater Occipital Nerve [GON] block). The quality of evidence was assessed using the GRADE approach. Results: After screening 1748 relevant articles, 9 RCTs comparing SPG block with other interventions (6 conservative treatments, 1 sham, 1 GON and 1 intranasal lidocaine puff) were included in this meta-analysis. SPG block demonstrated superiority over conservative treatment in pain reduction at 30 min, 1 h, 2 h, 4 h after interventions and treatment failures with "very low" to "moderate" quality of evidence. The SPG block failed to demonstrate superiority over conservative treatment in pain reduction beyond 6 h, need for rescue treatment, and adverse events. SPG block demonstrated superiority over intranasal lignocaine puff in pain reduction at 30 min, 1 h, 6 h, and 24 h after interventions. SPG block did not show superiority or equivalence in all efficacy and safety outcomes as compared to sham and GON block. Conclusion: Very Low to moderate quality evidence suggests the superiority of SPG block over conservative treatment and lignocaine puff for short-term pain relief from PDPH. PROSPERO Registration: CRD42021291707.


Subject(s)
Humans , Post-Dural Puncture Headache/therapy , Sphenopalatine Ganglion Block/methods , Pain , Randomized Controlled Trials as Topic , Lidocaine
15.
Arq. neuropsiquiatr ; 81(9): 795-802, Sept. 2023. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1520259

ABSTRACT

Abstract Background Genetic variants play a pathophysiological role in headaches, especially in migraine. The Mennonite group (MG) has been geographically and genetically isolated throughout its history, harboring a distinctive distribution of diseases. Objective To determine the characteristics of headaches in a group with direct Mennonite ancestry contrasting with other urban community members (control group [CG]). Methods Subjects with headaches were asked to complete a questionnaire covering: the type of headache, presence of aura, frequency and duration of attacks, pain location and severity, analgesic consumption, premonitory and postdromic manifestations, Depressive Thoughts Scale, Epworth Sleepiness Scale (ESS), General Anxiety Disorder-7, Patient Health Questionnaire-9 (PHQ-9), Migraine Disability Assessment, and Composite Autonomic System Score. Results We included 103 participants (CG: 45, Mennonite group [MG]: 58). Migraine was the most common headache (CG: 91.1%; MG: 81.0%; p = 0.172), followed by tension-type headache (CG: 8.9%; MG: 15.5%; p = 0.381). Aura was identified by 44.4% and 39.7% in the CG and MG, respectively (p = 0.689). The groups differed only concerning the frequency of retro-orbital pain (CG: 55.6%; MG: 32.8%; p = 0.027), PHQ-9 (CG: median 7, range 0 to 22; MG: median 5, range 0 to 19; p = 0.031) and ESS (CG: median 0, range 0 to 270; MG: median 0, range 0 to 108; p = 0.048) scores. Conclusion There were no major differences in the prevalence and clinical characterization of headaches between the MG and the CG. However, the latter showed more diffuse pain, sleepiness, and depressive symptoms. Specific genetic or epigenetic variants in Mennonite descendants might account for these differences.


Resumo Antecedentes Variantes genéticas desempenham um papel fisiopatológico nas cefaleias, especialmente na migrânea. O grupo menonita (GM) tem estado geográfica e geneticamente isolado ao longo de sua história, abrigando uma distribuição distinta de doenças. Objetivo Determinar as características das cefaleias em um grupo com ascendência menonita direta, comparando-as com as de outros membros da comunidade urbana (grupo controle [GC]). Métodos Participantes com cefaleia foram convidados a preencher um questionário abrangendo: tipo de cefaleia; presença de aura; frequência e duração dos ataques; localização e gravidade da dor; consumo de analgésicos; manifestações premonitórias e posdrômicas; Escala de Pensamentos Depressivos; Escala de Sonolência de Epworth (ESS); Transtorno de Ansiedade Geral-7 (GAD-7); Questionário de Saúde do Paciente-9 (PHQ-9); Avaliação de Incapacidade da Migrânea (MIDAS) e Escore do Sistema Autônomo Composto (COMPASS-31). Resultados Incluímos 103 participantes (GC: 45, GM: 58). A migrânea foi a cefaleia mais frequente (GC: 91,1%; GM: 81,0%; p = 0,172), seguida pela cefaleia tensional (GC: 8,9%; GM: 15,5%; p = 0,381). Aura foi identificada por 44,4% e 39,7% nos GC e GM, respectivamente (p = 0,689). Os grupos diferiram apenas com relação à frequência de dor retro-orbitária (GC: 55,6%; GM: 32,8%; p = 0,027), PHQ-9 (GC: mediana 7, amplitude 0 a 22; GM: mediana 5, amplitude 0 a 19; p = 0,031) e ESS (GC: mediana 0, amplitude 0 a 270; GM: mediana 0, amplitude 0 a 108; p = 0,048). Conclusão Não houve diferenças significativas na prevalência e caracterização clínica das cefaleias nos GM e GC. Entretanto, o último grupo mostrou mais dor difusa, sonolência e sintomas depressivos. Variantes genéticas ou epigenéticas específicas em descendentes de menonitas podem justificar tais diferenças.

16.
Arq. neuropsiquiatr ; 81(8): 734-739, Aug. 2023. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1513715

ABSTRACT

Abstract Background Peripheral nerve block (PNB) is usually performed in patients with migraine who are resistant to treatment with medications. Objective To compare the efficacy of PNB alone and PNB combined with prophylactic medications in migraine patients. Method The data on migraine patients who underwent PNB in our clinic between November 2019 and January 2022 were retrospectively reviewed. Blocks of the greater occipital nerve (GON), lesser occipital nerve (LON) and supraorbital nerve (SON) were performed upon admission and in the second week. Results The study included 116 patients. While 21 out of 39 episodic migraine (EM) patients continued to use prophylactic medications, 18 were followed up with PNB alone. While 49 out of 77 chronic migraine (CM) patients continued to use prophylactic medications, 28 were followed up with PNB alone. Comparison of the admission and second-month data of the patients who only underwent PNB and those who continued the drug treatment together with PNB in both the EM and the CM group showed that the number of days with pain, number of analgesics taken and scores on the Visual Analog Scale (VAS) and the Migraine Disability Assessment (MIDAS) were significantly reduced in both groups (p < 0.01). Comparison of the second-month data of the patients followed up with PNB alone and those followed up with PNB together with prophylactic medications showed that there was no significant difference between the EM and CM patients (p > 0.05). Conclusion Bilateral GON, LON and SON block with lidocaine injection seems to be an effective treatment on its own, without the need for prophylactic medications, in both EM and CM patients during a two-month follow-up.


Resumo Antecedentes O bloqueio de nervos periféricos (BNP) geralmente é realizado em pacientes com migrânea resistentes ao tratamento medicamentoso. Objetivo Comparar a eficácia do BNP isolado e do BNP combinado com medicamentos profiláticos em pacientes com enxaqueca. Método Os dados de pacientes com enxaqueca submetidos a BNP em nossa clínica entre novembro de 2019 e janeiro de 2022 foram revisados retrospectivamente. Bloqueios do nervo occipital maior (NOM), nervo occipital menor (NOM) e nervo supraorbital (NSO) foram realizados na admissão e na segunda semana. Resultados O estudo incluiu 116 pacientes. Enquanto 21 dos 39 pacientes com enxaqueca episódica (EE) continuaram a usar medicamentos profiláticos, 18 foram acompanhados apenas com BNP. Enquanto 49 dos 77 pacientes com enxaqueca crônica (EC) continuaram a usar medicamentos profiláticos, 28 foram acompanhados apenas com BNP. A comparação dos dados de admissão e do segundo mês dos pacientes que fizeram apenas BNP e daqueles que continuaram o tratamento medicamentoso junto com BNP, tanto no grupo EE quanto no grupo EC, mostrou que o número de dias com dor, o número de analgésicos tomados e os escores da Escala Visual Analógica (EVA) e da Avaliação da Incapacidade da Enxaqueca (AIE) foram significativamente reduzidos em ambos os grupos (p < 0,01). A comparação dos dados do segundo mês dos pacientes acompanhados apenas com BNP e aqueles acompanhados com BNP juntamente com medicações profiláticas mostrou que não houve diferença significativa entre os pacientes EE e EC (p > 0,05). Conclusão O bloqueio bilateral de NOM, NOM e NSO com injeção de lidocaína parece ser um tratamento eficaz por si só, sem a necessidade de medicamentos profiláticos, tanto em pacientes EE quanto com EC durante um seguimento de dois meses.

17.
Arq. neuropsiquiatr ; 81(8): 740-747, Aug. 2023. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1513718

ABSTRACT

Abstract Background Evaluation and treatment of primary and secondary headaches is a global public health challenge. Recognizing the epidemiological impact of headaches, a group of researchers linked to the Brazilian Headache Society proposed the Brazilian Headache Registry and drew up its initial protocol. Objective Here we describe the methods and preliminary data obtained from the pilot study. Methods This was a multicenter longitudinal observational study conducted between September 2020 and August 2021. Prospective data were collected in three specialist centers for headache care in states in southern and southeastern Brazil. Patients aged 18 years or older who sought care for headache in tertiary centers and who agreed to participate in the study, were considered eligible. Results Sixty-six patients were included in the pilot study: 43 (65%) from Rio Grande do Sul state and 23 (35%) from Minas Gerais state. Overall, 90% were female, and the subjects' mean age was 38.2 ± 11.2 years. Primary headaches accounted for 85.3% of the diagnoses made. Among secondary headaches, medication overuse headache was the most frequent type (7.1%). Conclusions The pilot study showed the feasibility of the research protocol developed for tertiary centers. The Brazilian Headache Registry will form a source of longitudinal data with the aim of contributing to better characterization of the various phenotypes of patients with primary and secondary headaches, and to detailing the use of health resources and identifying predictors of better clinical outcomes.


Resumo Antecedentes A avaliação e o tratamento das cefaleias primárias e secundárias são um desafio global de saúde pública. Reconhecendo o impacto epidemiológico das cefaleias, um grupo de pesquisadores vinculados à Sociedade Brasileira de Cefaleia propôs a criação de um Registro Brasileiro de Cefaleia e elaborou seu protocolo inicial. Objetivo Nesta publicação descrevemos os métodos e dados preliminares obtidos a partir do estudo piloto. Métodos Trata-se de um estudo prospectivo observacional longitudinal multicêntrico, realizado entre setembro de 2020 e agosto de 2021. Foram coletados dados em três centros especializados no atendimento de cefaleia, em estados da região sul e sudeste do Brasil. Pacientes com idade igual ou superior a 18 anos que procuraram os centros terciários por queixa de cefaleia e concordaram em participar do estudo foram considerados elegíveis. Resultados Sessenta e seis pacientes foram incluídos no estudo piloto, 43 (65%) do Rio Grande do Sul e 23 (35%) de Minas Gerais. Da amostra total, 90% eram do sexo feminino e a idade média dos sujeitos foi de 38,2 ± 11,2 anos. As cefaleias primárias representaram 85,3% dos diagnósticos realizados. Entre as cefaleias secundárias, a cefaleia por uso excessivo de medicamentos foi a mais frequente (7,1%). Conclusões O estudo piloto evidenciou a viabilidade do protocolo de pesquisa desenvolvido para centros terciários. O Registro Brasileiro de Cefaleia constituirá uma fonte de dados longitudinais com o objetivo de contribuir para melhor caracterização dos diversos fenótipos de pacientes com cefaleias primárias e secundárias, detalhar o uso de recursos de saúde e identificar preditores de melhores desfechos clínicos.

18.
Indian J Ophthalmol ; 2023 Jul; 71(7): 2845-2849
Article | IMSEAR | ID: sea-225141

ABSTRACT

Purpose: To study the safety and efficacy of optic nerve sheath fenestration surgery in patients with optic disc edema due to different etiologies. Methods: Records of 18 eyes of 15 patients who underwent optic nerve sheath fenestration for vision threatening optic disc edema were reviewed retrospectively, and results were analyzed. Improvement of visual acuity was the main measure of outcome. Improved visual fields, resolution of optic disc edema, diplopia, and headache were other benefits that were observed. Results: Fifteen patients between 13 and 54 years of age were included in the study. Three patients underwent successive bilateral surgery. Idiopathic intracranial hypertension was the most common cause for optic disc edema and was found in 80% of the patients. Mean preoperative logMAR acuity was ?1.9789 ± 1.46270, which improved to ?0.9022 ± 1.23181 (p < 0.005) in the operated eye, and mean logMAR acuity of contralateral eye improved from ?1.3378 ± 1.50107 to ?1.0667 ± 1.33813 (p < 0.05). Conclusion: Early optic nerve sheath fenestration is an effective modality for treating optic disc edema due to a wide myriad of causes and helps resolve the associated symptoms.

19.
Article | IMSEAR | ID: sea-222334

ABSTRACT

Wilson’s disease (WD) is an inborn error of copper metabolism caused by a mutation to the copper-transporting gene ATP7B. In the first decade of life, hepatic involvement predominates but neurological manifestations occur in the third or fourth decades. Studies showed Indian children with neuro WD present with behavior abnormality, speech and cognitive impairment, sub-clinical affection of visual pathway, and autonomic function. As a treatable disease, WD should be detected early in the course of the disease by any health professional at any care level, but the rare prevalence of the disease explains the lack of awareness of this disease. Even a high index of suspicion about this entity gets more difficult when the rare and atypical symptom is the only presentation of the disease. Here, we present the case of a 15-year-old girl with worsening headache for the past 3 months as the only neurological manifestation of WD, and that also without any evidence of hepatic involvement.

20.
Med. U.P.B ; 42(2): 71-75, jul.-dic. 2023. ilus
Article in Spanish | LILACS, COLNAL | ID: biblio-1443440

ABSTRACT

El síndrome de vasoconstricción cerebral reversible es poco frecuente y su fisiopatología aún no está bien dilucidada. Su presentación clínica se caracteriza por manifestaciones neurológicas como cefalea "en trueno", déficit focal, vómito, fotofobia y, en casos graves, puede tener complicaciones como eventos cerebrovasculares isquémicos o hemorrágicos. El diagnóstico se realiza mediante angiografía cerebral, angiotomografía o angioresonancia, las cuales documentan vasoconstricción de las arterias cerebrales con resolución espontánea, que en la mayoría de los casos es consistente con un buen pronóstico clínico. A continuación, se expone el caso de una paciente con vasoconstricción cerebral reversible y lesión miocárdica asociada, en donde se logra un diagnóstico mediante imágenes y tratamiento oportuno. La importancia del caso radica en informar sobre el reconocimiento temprano de una complicación miocárdica poco común del síndrome de vasoconstricción cerebral, pero con riesgo de morbimortalidad dentro del espectro de los cuadros cerebrovasculares.


Reversible Cerebral Vasoconstriction Syndrome is a rare condition, and its pathophysiology is not yet fully understood. Its clinical presentation is characterized by neurological manifestations such as "thunderclap" headache, focal deficit, vomiting, photophobia, and, in severe cases, it can lead to complications such as ischemic or hemorrhagic cerebrovascular events. The diagnosis is made through cerebral angiography, CT angiography, or magnetic resonance angiography, which demonstrate vasoconstriction of the cerebral arteries with spontaneous resolution, which in most cases is consistent with a good clinical prognosis. Here, we present the case of a patient with reversible cerebral vasoconstriction syndrome and associated myocardial injury, where a diagnosis was achieved through imaging and timely treatment. The importance of this case lies in raising awareness about the early recognition of a rare myocardial complication of reversible cerebral vasoconstriction syndrome, which carries a risk of morbidity and mortality within the spectrum of cerebrovascular disorders.


A síndrome de vasoconstrição cerebral reversível é rara e sua fisiopatologia ainda não é bem compreendida. Sua apresentação clínica é caracterizada por manifestações neuro-lógicas como cefaléia em trovoada, déficit focal, vômitos, fotofobia e, em casos graves, pode ter complicações como eventos cerebrovasculares isquêmicos ou hemorrágicos. O diagnóstico é feito por angiografia cerebral, angiotomografia ou angiorressonância , que documentam vasoconstrição das artérias cerebrais com resolução espontânea, o que na maioria dos casos é compatível com bom prognóstico clínico. A seguir, é apresentado o caso de um paciente com vasoconstrição cerebral reversível e lesão miocárdica associa-da, onde o diagnóstico é feito por imagem e tratamento oportuno. A importância do caso está em relatar o reconhecimento precoce de uma rara complicação miocárdica da síndrome de vasoconstrição cerebral, mas com risco de morbimortalidade dentro do espectro das doenças cerebrovasculares.


Subject(s)
Humans
SELECTION OF CITATIONS
SEARCH DETAIL